NCLEX Pharm Review

What are some examples of intramuscular routes?

• Vastus lateralis

• Ventrogluteal

• Deltoid

What are some examples of intravascular routes?

• IV

• PICC

What are some examples of subcutaneous routes?

• Abdomen

• Thigh

• Back of arm

What is a Schedule I drug?

• No currently accepted medical use

• High potential for abuse

What are examples of Schedule I drugs?

• Heroin

• LSD

• Marijuana

• Ecstasy

What is a Schedule II drugs?

• High potential for abuse

• Physical and psychological dependence

• Requires prescription

What are some examples of Schedule II drugs?

• Hydrocodone

• Cocaine

• Methadone

• Methamphetamines

• Oxycodones

What is a Schedule III drug?

• Requires new prescription after 6 months

• Moderate to low potential for abuse

What are some examples of Schedule III drugs?

• Tylenol with codeine

• Ketamine

• Anabolic steroids

What is a Schedule IV drug?

• Low risk of abuse and dependence

• Requires new prescription after 6 motns

What are examples of Schedule IV drugs?

• Xanax

• Soma

• Darvon

• Valium

What are Schedule V drugs?

• Low potential for abuse

• Does not require prescription (over the counter)

• Typically antitissuvies, antidiarrheals, and analgesics

What are examples of Schedule V drugs?

• Robitussin

• Lomotil

• Motofen

• Lyrica

What is a Category A drug?

• Controlled studies show no risk

• Possible fetal harm is remote

What is a Category B drug?

• No evidence of risk in humans based on animal studies alone or animal and human studies

What is a Category C drug?

• Risk cannot be ruled out, either concerning animal data or no data for humans

What is a Category D drug?

• Positive evidence of human fetal risk but use may be justified in some circumstances

What is a Category X drug?

• Contraindicated in pregnancy because of evidence of fetal risk

What should you monitor for antihypertensives?

• Weight, VS, hydration

• Renal function, coagulation

What is patient teaching for antihypertensives?

• Avoid hot tubs and sauncas

• Do not discontinue abruptly

• Rise slowly to prevent orthostatic hypertension

What do antihypertensives do?

• Lower blood pressure

What is the medication class that commonly end in “-pril”?

• ACE inhibitor

What is the MOA of ACE Inhibitors?

• Block conversion of angiotensin I to angiotensin II

What class of medications are the following:

• Benazepril

• Lisinopril

• Captopril

• ACE Inhibitors

What is a common side effect of ACE inhibitors?

• Persistent dry cough

What is an adverse effect of ACE Inhibitors?

• Angioedema

When are ACE Inhibitors contraindicated?

• Not for use in 2nd and 3rd trimester of pregnancy

What is the medication class that commonly ends in “-tan”?

• Angiotensin II Receptor Blockers (colloquially known as ARBs within the medical community)

What is the MOA of Angiotensin II Receptor Blockers (ARBs)?

• Selective block bindings of angiotensin II to AT1 receptors

What is the medication class of the following:

• Losartan

• Valsartan

• ARBs

What is an adverse effect of ARBs?

• Angioedema

What is the medication class that commonly ends in “-ine”

• Calcium channel blockers

What is the MOA of calcium channel blockers?

• Slow movement of Ca into smooth muscles, thereby causing dilation of the arterials and decreases BP

What is the medication class of the following:

• Amiodipine

• Nifedipine

• Verpamil

• Dilitiazem

• Amiodipine

• Calcium channel blockers

What kind of drug is used for angina and hypertension?

• Calcium channel blockers

What does verpamil and diltiazem treat?

• SVT

• Atrial fib/flutter

What can an overdose of calcium channel blockers cause?

• Reflex tachycardia

What other medication classes should you use caution with when taking calcium channel blockers?

• Digoxin

• Beta blockers

What are calcium channel blockers contraindicated with?

• Heart failure

• Heart block

• Bradycardia

• Grapefruit juice

How should calcium channel blockers be stopped?

• Taper dose when stopping

What is the medication class the commonly ends in “-sin”

• Alpha adrenergic blockers

What is the medication class of the following:

• Tamsulowin, Prazosin

• Alpha adrenergic blockers

What are alpha adrenergic blockers widely used in?

• Prostate problems for male patients

What should you use caution with when taking prazosin?

• NSAIDS

What is the medication class of the following:

• Clonidine

• Methyldopa

• Centrally acting alpha 2 agonists

What kind of drugs are used to treat hypertensive crises?

• Centrally acting alpha 2 agonists

What should you use caution with when taking centrally acting alpha 2 agonists?

• Hepatic failure

• Anticoagulatns

• MAOIs

• Methyldopa

• CVA

• MI

• Depression

• Lactation

What are side effects of centrally acting alpha 2 agonists?

• Sores

• Black tongue

What should you observe for when taking centrally acting alpha 2 agonists?

• Rebound hypertension

What is the medication class that commonly ends in “-lol”?

• Beta blockers

What is the medication class of the following:

• Metoprolol

• Propranolol

• Labetalol

• Atenolol

• Beta blockers

What are beta blockers used for?

• Tachydysrhytmias

• HF

• MI

What should you monitor for when taking beta blockers?

• Heart rate

What are beta blockers contraindicated in?

• Advanced heart blocks

What do cardiac glycosides do?

• Increase the force and velocity of myocardial contractions to improve stroke volume and OP in the HF and atrial fib

What medication class is digoxin?

• Cardiac glycoside

What should you use caution with when taking digoxin?

• When taking thiazide and loop diuretics

What can ARBs/ACE inhibitors lead to when taken with cardiac glycosides?

• Hyperkalemia

What happens when taking verpamil with cardiac glycosides?

• May lead to toxicity risks

What should you assess before giving cardiac glycosides?

• Monitor apical pulse for 1 minute

What are signs and symptoms of digoxin toxicity?

• GI symptoms

• Anorexia

• Nausea

• CNS symptoms: fatigue, diplopia, yellow/green or white halos

What should you give if there are dysrhytmias resulting fromm digoxin toxicity?

• Phenytoin or lidocaine

What should you give if there is bradycaradia resulting form digoxin toxicity?

• Atropine

What do Antilipemics do?

• Decrease LDL and increase HDL with diet, exercise, and weight control

What med class are statins?

• Antilipemic

What med class are cholesterol absorption inhibitors?

• Antilepemics

What kind of drugs do statins interact with?

• Digoxin

• Warfarin

• Thyroid meds

• Thiazide diuretics

• Phenobarbital

• NSAIDS

• Tetracycline

• Beta Blockers

• Gemfibrozil

• Glyburide

• Oral Contraceptives

What kind of bev should you not take with statins?

• Grapefruit

What type of drug is ezetimibe?

• Cholesterol absorption Inhibitor

What types of drugs are ezetimibe used with?

• Other cholesterol medications

When should cholesterol absorption inhibitors be taken?

• 2 hours before antilepemics

  • or

• 4 hours after antilepemics

Of glucocorticoids and beta agonists, which should be taken first in relation to respiratory medications?

• Beta agonists

How long should one hold their breath after inhaling beta agonists or glucocorticoids?

• 5 to 10 seconds

What do bronchodilators do?

• Open airways

What is the MOA of Beta2 Adrenergic Agonists?

• Activate beta receptors in bronchial smooth muscle

What type of conditions should albuterol SABA be used with caution?

• Acute asthma attacks

What bronchodilator is short acting (5-15 minutes)?

• Albuterol

  • AKA rescue inhaler

What bronchodilator is long acting?

• Terbutaline

What med class can reduce the effects of bronchodilators?

• Beta blockers

What are side effects of bronchodilators?

• Tachycardia

• Palpitations

• Tremors

What is the MOA of methylxanthines?

• Relax bronchial smooth muscles to bronchodilate

What is the indication of methylxanthines?

• Long term control of asthma

What type of drugs are aminophylline and theophylline?

• Methylxanthines

What are methylxanthines contraindicated with?

• Ulcers

• DM

• Hyperthyroid

• Heart disease

• Angina

• Hypertension

What are side effects of methylxanthines?

• Restlessness

• Irritability

What are toxic effects of methylxanthines?

• Tachycardia

• Tachypnea

• Seizures

What should not be consumed with methylxanthines?

• Alcohol

• The smoking

• Caffeine

What is the antidote for methylxanthine toxicity?

• Charcoal

What should be given for dysrhythmias as a result of methylxanthines?

• Lidocaine

What is the MOA of leukotrine modifiers?

• Decrease mucus, inflammation, and airway edema

What are the indications for leukotrine modifiers?

• Asthma

• But not for acute attacks, that’s the purview of albuterol

What is an adverse effect of leukotriene modifiers?

• Liver disease

What are side effects of leukotrien modifiers?

• Elevated liver enzymes

• Warfarin and theophylline toxicity

• Increase levels of beta blockers that can cause hypotension and bradycardia

Shouald leukotrine modifiers be stopped abruptly?

• No, when is a drug ever stopped abruptly?

When should leukotrine modifiers be taken?

• In the evening

Where should leukotriene modifiers be placed?

• In the mouth

• Soft foods but never liquids

What leukotrine modifier is given to those over 12 months old?

• Montelukast

What leukotrine modifier is given to those over 12 years old?

• Zileuton

What leukotrine modifier is given to those over 5 years old?

• Zafirlukast